Provider Demographics
NPI:1588968614
Name:FAMILY VISITOR PROGRAM OF GARFIELD COUNTY, INC.
Entity type:Organization
Organization Name:FAMILY VISITOR PROGRAM OF GARFIELD COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:MARET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-945-1234
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-1845
Mailing Address - Country:US
Mailing Address - Phone:970-945-1234
Mailing Address - Fax:970-928-8328
Practice Address - Street 1:401 23RD ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4363
Practice Address - Country:US
Practice Address - Phone:970-945-1234
Practice Address - Fax:970-928-8328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO194025251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care